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Exam (elaborations) SAEM

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The answer is A. A fluctuant, indurated area such as that pictured and described, tends to not respond to antibiotics (which cannot penetrate well into the abscess cavity). Cruciate incisions are unnecessary and risk wound healing problems. A 30 gauge needle is too small, and needle drainage of an abscess in this location is not generally used (it is more likely appropriate in facial abscesses). 6What does the dotted line in the figure depict? [image] Figure used with permission from Hamilton et al, Emergency Medicine: An approach to clinical problem-solving A. Placement site for skin clamps. B. The needle entry angle that optimizes eversion of sutured skin edges. C. The approach for subcuticular suture. D. The injection plane for local anesthesia infiltration. E. Use of a "finder needle" to mark suture entry points.B. The needle entry angle that optimizes eversion of sutured skin edges. The answer is B. Eversion of the skin edges is maximized by directing the needle entry as shown in the figure. Injection for local anesthesia should usually be performed through the wound, rather than through intact skin. Use of skin clamps can damage tissue; in cases where skin stabilization is needed gentle forceps application is preferred. Subcuticular sutures are placed deep to the skin. The components of the Figure (which is a photograph taken of the female perineal region) depict __________ (in the top of the Figure) which can be treated by placement of a __________ (in the lower part of the Figure): A. a cystocele -- pessary B. a benign tumor -- brachytherapy applicator C. a Bartholin's cyst -- Word catheter D. an inguinal lymph node -- gel-applicator for antibiotics administration E. a urinoma -- pediatric Foley catheterC. a Bartholin's cyst -- Word catheter The answer is C. The patient's Bartholin's cyst will be drained, and placement of a

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NSG 3100 Exam 3 Test Your
Knowledge questions and answers
1) The nurse would call the primary care provider immediately for which laboratory
result?
1. Hgb = 16 g/dL for a male client
2. Hct = 22% for a female client
3. WBC = 9 × 103/mL3
4. Platelets = 300 × 103/mL3✔✔Answer: 2. Rationale: Option 2 is very low and can
lead to death. The client's red blood cells participate in oxygenation. Options 1, 3,
and 4 are within normal range and should not be reported to the primary care
provider. Cognitive Level: Applying. Client Need: Physiological Integrity. Nursing
Process: Implementation. Learning Outcome: 34-3.

2) A 78-year-old male client needs to complete a 24-hour urine specimen. In
planning his care, the nurse realizes that which measure is most important?
1. Instruct the client to empty his bladder and save this voiding to start the collection.
2. Instruct the client to use sterile individual containers to collect the urine.
3. Post a sign stating "Save All Urine" in the bathroom.
4. Keep the urine specimen in the refrigerator.✔✔Answer: 3. Rationale: Option 3 is
the most important nursing measure. This will inform the staff that the client is on a
24-hour urine collection. Option 1 is not appropriate since the first voided specimen
is to be discarded. Option 2 is not an appropriate nursing measure since the
specimen container is clean not sterile, and one container is needed—not individual
containers. Option 4 is inappropriate because some 24-hour urine collections do not
require refrigeration. Cognitive Level: Understanding. Client Need: Physiological
Integrity.Nursing Process: Implementation. Learning Outcome: 34-6.

3) The client has a urinary health problem. Which procedure is performed using
indirect visualization?
1. Intravenous pyelography (IVP)
2. Kidneys, ureter, bladder (KUB)
3. Retrograde pyelography
4. Cystoscopy✔✔Answer: 2. Rationale: A KUB is an x-ray of the kidneys, ureters,
and bladder. This does not require direct visualization. Option 1 is an IVP, an
intravenous pyelogram, which requires the injection of a contrast media. Option 3 is
a retrograde pyelography, which requires the injection of a contrast media. Option 4
is a cystoscopy, which uses a lighted instrument (cystoscope) inserted through the
urethra, resulting in direct visualization. Cognitive Level: Remembering. Client Need:
Physiological Integrity. Nursing Process: Assessment. Learning Outcome: 34-8

4) Which noninvasive procedure provides information about the physiology or
function of an organ?
1. Angiography
2. Computerized tomography (CT)
3. Magnetic resonance imaging (MRI)
4. Positron emission tomography (PET)✔✔Answer: 4. Rationale: This type of nuclear
scan demonstrates the ability of tissues to absorb the chemical to indicate the

, physiology and function of an organ. Option 1 is an invasive procedure that focuses
on blood flow through an organ. Options 2 and 3 provide information about density of
tissue to help distinguish between normal and abnormal tissue of an organ.
Cognitive Level: Remembering. Client Need: Physiological Integrity. Nursing
Process: Assessment. Learning Outcome: 34-9

5) When assisting with a bone marrow biopsy, the nurse should take which action?
1. Assist the client to a right side-lying position after the
procedure.
2. Observe for signs of dyspnea, pallor, and coughing.
3. Assess for bleeding and hematoma formation for several days after the procedure.
4. Stand in front of the client and support the back of the neck and
knees.✔✔Answer: 3. Rationale: Bone marrow aspiration includes deep penetration
into soft tissue and large bones such as the sternum and iliac crest. This penetration
can result in bleeding. The client should be observed for bleeding in the days
following the procedure. Option 1 is a nursing action during a liver biopsy. Option 2 is
a nursing action for a thoracentesis, and Option 4 is a nursing action for a lumbar
puncture. Cognitive Level: Applying. Client Need: Physiological Integrity. Nursing
Process: Implementation. Learning Outcome: 34-10

6) During an assessment, the nurse learns that the client has a history of liver
disease. Which diagnostic tests might be indicated for this client? Select all that
apply.
1. Alanine aminotransferase (ALT)
2. Myoglobin
3. Cholesterol
4. Ammonia
5. Brain natriuretic peptide or B-type natriuretic peptide (BNP)✔✔Answer: 1 and 4.
Rationale: ALT is an enzyme that contributes to protein and carbohydrate
metabolism. An increase in the enzyme indicates damage to the liver. The liver
contributes to the metabolism of protein, which results in the production of ammonia.
If the liver is damaged, the ammonia level is increased. Options 2, 3, and 5
(myoglobin, cholesterol, and BNP) are relevant for heart disease. Cognitive Level:
Applying. Client Need: Physiological Integrity. Nursing Process: Assessment.
Learning Outcome: 34-2.

7) The nurse practitioner requests a laboratory blood test to determine how well a
client has controlled her diabetes during the past 3 months. Which blood test will
provide this information?
1. Fasting blood glucose
2. Capillary blood specimen
3. Glycosylated hemoglobin
4. GGT (gamma-glutamyl transferase)✔✔Answer: 3. Rationale: A glycosylated
hemoglobin will indicate the glucose levels for a period of time, which is indicated by
the nurse practitioner. Options 1 and 2 will provide information about the current
blood glucose, not the past history. Option 4 is used to assess for liver disease.
Cognitive Level: Remembering. Client Need: Physiological
Integrity. Nursing Process: Planning. Learning Outcome: 34-2

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